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What do you think? This is a difficult case. Only one answer is correct. I suspect only well read people will be able to get this.
PA CXR | |  | |  | |


































Aneurysm – Usually atherosclerotic rarely mycotic/traumatic | Dissection | Aortic Valve disease – Stenosis or Regurgitation | Cystic medial necrosis- Marfans / Ehlers-Danlos (young patients) | Congenital-Coarctation,PDA |

















Scleroderma/Raynauds | Psoriatic Arthropathy | Hyperparathyroidism | Thermal Injury - Frostbite, Burns, Electrical | Neuropathic - Diabetes, Syrinx, Leprosy, Asymbolia | Dermatological - Porhyria, Epidermolysis Bullosa | Toxins - Snake, Scorpion bites | Congenital- Infants of epileptic mothers (phenytoin) |


Industrial PVC exposure | Hajdu-Cheney disease | Hyperparathyroidism (very unusual presentation) |















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